"Keep the government away from my Medicare!"

Jill

Brilliant at Breakfast

Friday, July 31, 2009

When Barack Obama told the story about a woman saying "Keep the government away from my Medicare" the other day, I figured he was just repeating the old joke, one that's been circulating ever since 1993 to demonstrate just how moronic Americans (in this case older Americans) are about health care. In his column today, Paul Krugman cites an actual example of someone saying this:

At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program — but the voter, Mr. Inglis said, “wasn’t having any of it.”

It’s a funny story — but it illustrates the extent to which health reform must climb a wall of misinformation. It’s not just that many Americans don’t understand what President Obama is proposing; many people don’t understand the way American health care works right now. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved, even in private insurance.

And that government involvement is the only reason our system works at all.

The key thing you need to know about health care is that it depends crucially on insurance. You don’t know when or whether you’ll need treatment — but if you do, treatment can be extremely expensive, well beyond what most people can pay out of pocket. Triple coronary bypasses, not routine doctor’s visits, are where the real money is, so insurance is essential.

Yet private markets for health insurance, left to their own devices, work very badly: insurers deny as many claims as possible, and they also try to avoid covering people who are likely to need care. Horror stories are legion: the insurance company that refused to pay for urgently needed cancer surgery because of questions about the patient’s acne treatment; the healthy young woman denied coverage because she briefly saw a psychologist after breaking up with her boyfriend.

And in their efforts to avoid “medical losses,” the industry term for paying medical bills, insurers spend much of the money taken in through premiums not on medical treatment, but on “underwriting” — screening out people likely to make insurance claims. In the individual insurance market, where people buy insurance directly rather than getting it through their employers, so much money goes into underwriting and other expenses that only around 70 cents of each premium dollar actually goes to care.

Still, most Americans do have health insurance, and are reasonably satisfied with it. How is that possible, when insurance markets work so badly? The answer is government intervention.

Most obviously, the government directly provides insurance via Medicare and other programs. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Today, Medicare — which is, by the way, one of those “single payer” systems conservatives love to demonize — covers everyone 65 and older. And surveys show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance.

Still, most Americans under 65 do have some form of private insurance. The vast majority, however, don’t buy it directly: they get it through their employers. There’s a big tax advantage to doing it that way, since employer contributions to health care aren’t considered taxable income. But to get that tax advantage employers have to follow a number of rules; roughly speaking, they can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees.

And it’s thanks to these rules that employment-based insurance more or less works, at least in the sense that horror stories are a lot less common than they are in the individual insurance market.

So here’s the bottom line: if you currently have decent health insurance, thank the government. It’s true that if you’re young and healthy, with nothing in your medical history that could possibly have raised red flags with corporate accountants, you might have been able to get insurance without government intervention. But time and chance happen to us all, and the only reason you have a reasonable prospect of still having insurance coverage when you need it is the large role the government already plays.

I wonder just how many people are aware of what would happen to even the crappy insurance they have now if the government had zero involvement. What do they think would happen if there were even less regulation than there is now; which is a system in which insurance companies can do whatever they want -- drop you if you ever had a mole removed, refuse to cover you because 25 years ago you saw a therapist for a few weeks after a loved one died, deny coverage after an expensive procedure because a paper-pusher in a hospital forgot to dot an "i" on a form. Imagine a system where greed is even more operative than it is now.

I've been appalled at the people who seem to actually believe that the Angry Negro™ in the White House is going to send people door to door throughout America essentially saying "My name is Inigo Montoya. You killed my father. Prepare to die.". Often it seems that the entire health care debate on the right boils down to "Can't you see that man is a ni-?" Imagine how much better off we, and the entire health care debate, would be if these people could just admit that it's all about Fear of a Black Planet

Copyright 2009 Brilliant at Breakfast

Sorting Myth From Reality

Faiz Shakir, Amanda Terkel, Matt Corley, Benjamin Armbruster, and Nate Carlile

The Progress Report

July 29, 2009

Congress may be moving one step closer to reforming health care, as the Senate Finance Committee nears agreement on a bipartisan compromise. Yesterday, Senate Majority Leader Harry Reid (D-NV) vowed that the committee would wrap up its work by the end of next week. This deal, however, will most likely not contain a public option or a mandate for employers to provide employees with health insurance. While many progressives are upset with this outcome, it's important to remember that this is not the final legislation: After the bill passes the Senate Finance Committee, it will still need to be reconciled with the Senate Health, Education, Labor and Pensions Committee and House bills, both of which include a public option. While these lawmakers continue to hammer out the details, many Republicans, conservative activists, and industry lobbyists continue to spread misinformation and push for indefinite delays in the hope of killing any chance at change. Yesterday in a "tele-town hall" sponsored by AARP, President Obama addressed this obstruction, underscoring that no one is talking about "socialized medicine," despite what conservatives are charging. "I think that we've been so accustomed to hearing those phrases that sometimes we can't sort out the myth from the reality," Obama said.

NOT GOING FAR ENOUGH: Instead of a public option, the Senate Finance Committee plan will likely include regional, non-profit cooperatives, which have been pushed by Sen. Kent Conrad (D-ND). Though Conrad asserts that his co-ops will accomplish "much of what those who want a public option are calling for," co-ops have historically had trouble fulfilling their goal of offering small employers and individuals a choice in health plans and reducing costs. The inclusion of a so-called "free rider" penalty instead of an employer mandate comes from the misguided belief that a mandate would lead employers to stop offering insurance. The free rider provision would require employers not offering coverage to pay a penalty "based on how much the government ends up paying for workers' coverage." The problem with this plan, notes the Wonk Room's Igor Volsky, is that "employers in low cost areas would be subsidizing workers in high cost areas, and vice versa." Additionally, this free rider provision would make it "considerably more expensive for employers who do not offer health insurance to hire workers from lower-income families," so employers would "have strong incentives to tilt hiring toward people who have a spouse/parent with a good income." Fivethirtyeight.com's Nate Silver observes that the Senate Finance proposal "looks an awful lot like the incomplete draft of the HELP Committee's bill that the CBO scored last month," which was widely criticized for costing $1 trillion over the next 10 years but only reducing the number of uninsured by 16 million. It was only when the final HELP bill came out -- which included both a public option and an employer mandate -- that the CBO estimated that it would reduce the uninsured ranks by 37 million for the same cost.

PROUD OBSTRUCTIONISTS: Conservatives have been trying to claim that they are in favor of reform and that it's the Democrats' fault that the process is being slowed down. "That they have had to slow down is because so many Democrats, including so many Democrat governors, know this is something that can't be rushed, because it's very dangerous in some of the forms it could be," said Mississippi Gov. Haley Barbour (R) this week. On Fox News yesterday, Sen. Jon Kyl (R-AZ) claimed, "This isn't being held up by Republicans." Unfortunately, a delay and kill strategy is exactly what conservatives are doing. Earlier this month, Sen. Charles Grassley (R-IA) declared, "I take pride with being an obstructionist." Sen. Pat Roberts (R-KS) has similarly said, "Maybe we could put something underneath that and say: 'Slow Down' or maybe in the language of my State 'Whoa.'" These talking points mirror a political memo written by conservative strategist Alex Castellanos, which advised, "If we slow this sausage-making process down, we can defeat it, and advance real reform that will actually help." Industry interests have been teaming up with conservatives on this strategy, with one lobbyist admitting that they are purposely "creating delays" in order to better seize any "opportunity to outright kill a proposal."

SPREADING LIES, INFLAMING FEARS: Conservatives are attempting to create these delays through misinformation and outright intimidation. A group called "Patients First," a project of the lobbyist-funded Americans for Prosperity, has been going around the country hosting tea parties in opposition to "government-run health care." Republicans are now attacking a small provision in the House bill that would allow Medicare to cover advanced care consulting. The Republican National Committee sent out a research document yesterday claiming the House legislation is encouraging euthanasia. Rep. Virginia Foxx (R-NC) went on the House floor and said it was placing "seniors in a position of being put to death by their government." Of course, these claims are baseless fear-mongering. The House bill would simply give seniors the option of speaking with an expert about advanced care issues, such as living wills. "This measure would not only help people make the best decisions for themselves but also better ensure that their wishes are followed," responded AARP Executive Vice President John Rother. "To suggest otherwise is a gross, and even cruel, distortion."

Copyright 2009 thinkprogress.org

'The Wacko Wing'

Faiz Shakir, Amanda Terkel, Matt Corley, Benjamin Armbruster, and Nate Carlile

The Progress Report

July 27, 2009

Last Thursday, CNN President Jon Klein sent an e-mail to a handful of the network's "Lou Dobbs Tonight" staffers informing them that he considered one of the stories pursued by the infamously anti-immigrant host to be "dead." On his radio show the week before, Dobbs declared that President Obama needed to "produce a birth certificate," picking up on a thoroughly debunked conspiracy theory that claims Obama was not born in the United States, and the birth certificate released by his campaign last year was fake. Dobbs repeatedly pushed the "birther" cause despite the fact that his colleagues at CNN have repeatedly called the story "total bull." In fact, while guest-hosting Dobbs' own show on July 17, Kitty Pilgrim refuted the fringe theory, saying, "CNN has fully investigated the issue, found no basis for the questions about the president's birthplace, but the controversy lives on, especially on the Internet." But Dobbs has persisted, attacking his critics as "limp-minded, lily-livered lefties" who hate him because he has "the temerity to inquire as to where the birth certificate was." As Dobbs continued to air the conspiracy theory, Klein backed off his admonition of the host, telling the Los Angeles Times that Dobbs had handled the issue in a "legitimate" manner and "if there are future news pegs, then we have to take that story as it comes." On Sunday, Washington Post media critic Howard Kurtz used his CNN show to chastise media outlets that "give the birthers any airtime" to repeat their "ludicrous claims." Kurtz specifically criticized Dobbs for not acting "responsible."

BORN IN THE USA: Obama was born on Aug. 4, 1961 in Honolulu, Hawaii. This date is on the Certification of Live Birth released by the Hawaii Department of Health last year at the request of Obama. Birthers like Dobbs point to the fact that the campaign released the "short form" certification rather than the "long form" -- which is drawn up by the hospital and contains more information -- as the crux of their argument that the President is hiding something. But as FactCheck.org noted when they investigated and debunked claims about Obama's birth certificate, "the Hawaii Department of Health's birth record request form does not give the option to request a photocopy of your long-form birth certificate," and "their short form has enough information to be acceptable to the State Department." Birthers, like conspiracy theorist Jerome Corsi, claim that the certificate posted by the Obama campaign was "a false, fake birth certificate," but its authenticity has been independently confirmed by FactCheck.org, which examined it in person and declared that "it is real and three-dimensional." Additionally, on Oct. 31, 2008, Dr. Chiyome Fukino, director of the Hawaii Department of Health, issued a statement saying that he had "personally seen and verified that the Hawaii State Department of Health has Sen. Obama's original birth certificate on record in accordance with state policies and procedures." Definitive proof of Obama's Hawaii birth has also been found in the archives of two Hawaii newspapers, the Honululu Advertiser and Honolulu Star-Bulletin, which both printed birth announcements days after Obama was born in 1961. Birth announcements in those papers are placed by the state Department of Health, not the family.

RIGHT-WING MEDIA GIVES VOICE: Dobbs isn't the only media personality giving voice to the birthers. As PolitiFact's Robert Farley wrote last month, "the conservative WorldNetDaily.com Web site is the conductor of the Birther train." The far-right outlet, which sells "Where's The Birth Certificate?" bumper stickers, convinced someone to ask White House Press Secretary Robert Gibbs about the conspiracy in May. The birther theory has also been pushed by bigger names in the right-wing media. Before the 2008 election, radio host Rush Limbaugh speculated that Obama may have gone to Hawaii to visit his dying grandmother to take care of "this birth certificate business." Since then, Limbaugh has joked, "[W]hat do Obama and God have in common? Neither has a birth certificate." Earlier this month, Limbaugh stepped it up a notch, declaring that "Barack Obama has yet to prove he's a citizen." Fox News has also elevated the birther conspiracy, running headlines like "Should Obama Release Birth Certificate?" on its Fox Nation website and running reports on birther-based lawsuits on its news shows. Fox's Sean Hannity has aired claims that "the president is not, in fact, a legitimate citizen by birth" and asked a caller on his radio show if he had "ever seen" Obama's birth certificate.

THE BIRTHER BILL: In March, Rep. Bill Posey (R-FL) introduced legislation requiring "presidential candidates to produce copies of their birth certificates and other documentation to prove natural-born citizenship." Posey's bill has gathered nine co-sponsors in the House. Trying to explain why he introduced the bill, Posey issued a statement saying, "This bill, by simply requiring such documentation for future candidates for president, will remove this issue as a reason for questioning the legitimacy of a candidate elected as president." But Posey has undermined this seemingly innocuous rationale for his legislation by outright accusing Obama of hiding something on a right-wing Internet radio show. "The only people that I know who are afraid to take drug tests are the people who use drugs," said Posey. Claiming that he hadn't looked at the evidence, Posey previously told the Orlando Sentinel, "I can't swear on a stack of Bibles whether he is or isn't" a citizen. On MSNBC's Hardball last week, host Chris Matthews challenged one of the bill's co-sponsors, Rep. John Campbell (R-CA), telling him that "what you're doing is appeasing the nutcases...you're verifying the paranoia out there." Asked if he believed Obama was a citizen, Campbell responded, "as far as I know, yes." Matthews retorted, "as far as you know? I'm showing you his birth certificate!" Matthews is correct that many conservative lawmakers are comfortable "feeding the wacko wing." Just today, Politico reported that Sen. James Inhofe (R-OK) said birthers "have a point." "I don't discourage it," said Inhofe.

Copyright 2009 thinkprogress.org

In a Sense, Abroad Part Quatre: You Bet They Canada!

Steven Weber

The Huffington Post

July 24, 2009

I am currently in the northern territories on a work assignment, as seeking gainful employment in the wonderful world of television will occasion one to do.

Our famously pleasant upstairs neighbour (note my use of "u" in "neighbor" out of deference to my host country, a selfless act of diplomacy all American representatives abroad should engage in) has made my stay famously pleasant and I have been privileged to observe close-up what some people in the American media have told me was bad and ugly and evil and vile and stinky and Commie and shitty and bad. And also bad. And did I mention bad?

And it makes me wanna heave a curling stone, drain a can of Molson's and yodel O, Canada! O, your hockey. O, your syrup. O, your Leonard Cohen. O, your exported comedy.

And O by the way did you know that according to the largest survey on primary health care ever conducted in Canada that most people have high praise for their family doctor and a staggering 92% would recommend their physician to a relative or friend; that they have excellent access to primary care and experience relatively short wait times for treatment and that the concept of prevention is strongly built into the public's understanding of viable and efficient national health care?

And they're not teeth-gnashing, flag-waving Red menaces. Well, maybe during the Stanley Cup playoffs they are.

For you see, Canadians enjoy a quality of health care (and, subsequently, quality of life) that has been demonized by the bitter mouthpieces for the corporate health cabal in these United States, who themselves have much to lose if American citizens choose a national health care plan:

Firstly, they would lose all the profits wrung from an aging and increasingly unfit population (66% of Americans over age 20 are overweight or obese) which is dependent on exorbitantly priced medications.

Secondly, they would lose their power to influence political policies involving unregulated production or research into more affordable medicines, policies which ultimately favor them and their fellow capitalisto fuck-buddies over the ailing and elderly.

And thirdly, what I just said but double.

How many cases of Hobson's Choice must Americans hear before they realize that they are being colossally ripped off; that the pay-or-die option so generously offered by the medical and drug industry actually, really does not represent the best care in the world? All the fear-mongering, political obstruction and verbal gymnastics opponents of a national health care plan for the United States have been spewing are nothing more than frantic attempts to keep money in the bottomless pockets of Big Pharma. And the stranglehold the pharmaceutical industry has on the country is the same one the banks have, tenaciously hanging onto their primacy as the physical well-being of the country it professes to care about ebbs away.

In fact, the greatest threat to the health of individuals in the US is the lack of a nationalized, affordable health care program. Why the spin to cast it as socialist or downright deadly? Because to some, it ain't medicine which makes you live a better life.

It's money.

And that's the only reason everyone from the Blue Dog to the fair and balanced Fox (craven animals which have a tendency to lick their own testicles and consume feces -- just saying) hates the idea of people paying less and ultimately becoming healthier and detached from Big Pharma's slow drip.

And listen, Canadians also seem to have skirted (for now, anyway) the housing and real estate crisis which has gripped its big shot, big-assed cousin by their wallets. Canadians are still making tidy profits on sales and construction, the same ones Americans enjoyed for so many years of blissful indulgence. Only, the Canadians have hold of their senses. And it shows in their stable economy and satisfied health care recipients.

And once again, ONCE AGAIN (Zeus, it is so boring to have to say it over and over) the obvious need for universal health care, the kind that works so well in most other technologically advanced countries, is prevented from being implemented by the same folks whose job, apparently, is to obfuscate the necessities rightfully due all American citizens; who brought us the tragically corrupt morass in Iraq; who instigated the unregulated banking fiasco; who toil in the dark cause of relentless profiteering while cynically cloaked as Conservatism, as Republicanism, as reliable news and information, as food and drug regulation -- you name it, they corrupt it. The people who want to bring health care down want to bring you down.

From up north it's easy to see the cure for what ails.

Copyright 2009 HuffingtonPost.com

Blue Dogs heel when lobbyists whistle

Why their vaunted "fiscal conservatism" targets health reform -- and never Pentagon waste


Joe Conason

salon.com

Friday, Jul 24, 2009

Nobody could be better positioned than the Democrats who call themselves "Blue Dogs" to sabotage healthcare reform, the primary objective of their president and the signature issue of their party for more than 60 years. Thanks to fawning publicity in the mainstream media that persistently describes them as fiscally conservative and ideologically moderate, the Blue Dogs enjoy an almost unassailable position in the middle of Washington's stunted political spectrum.

Certainly the Blue Dogs are astute players of the game, their power enhanced by their willingness to echo Republican rhetoric while enjoying the perks and prerogatives of Democratic power. But this is a cynical group indeed, whose reputation for fiscal probity is grossly inflated -- and whose loyalty to corporate interests, over and above the priorities of their party and the welfare of their constituents, is a darkening stain.

What supposedly troubles the Blue Dogs these days is the estimated cost of healthcare reform. By their calculations, a trillion dollars over 10 years represents an unsustainable expenditure, even if the program succeeds in providing universal quality coverage. The chairman of the Blue Dog healthcare task force, Rep. Mike Ross, D-Ark., has repeatedly threatened to kill any reform bill that increases the deficit. "We have to take steps to hold healthcare costs to the rate of inflation, or we will never balance our federal budget again, and health insurance costs will continue to become less and less affordable for the American people," he said last week.

Holding healthcare costs to the rate of inflation is a laudable if unlikely goal for Ross and his fellow Blue Dogs, but the simple fact is that their concern over costs and deficits is highly selective -- and their claim to fiscal conservatism is utterly unearned. That should be instantly obvious to anyone who glances at the Mike Ross House Web site, where all of his puffery about holding down the deficit and saving taxpayer money gives way to his boasting about the pork he brings home to Arkansas. His most recent spate of news releases touts earmarks adding up to $66 million, mostly in the House Energy and Water appropriations bill. (If every member of Congress snatched that amount, the total would far exceed $300 billion, by the way.) That doesn't include the $87 million that Ross claimed for Arkansas to weatherize homes and schools, courtesy of the president's stimulus legislation.

Chances are that the river and port improvement projects forming the bulk of the Ross earmarks are perfectly legitimate -- and that may well be true of most of the earmarks that the other Blue Dogs regularly grab for their home districts. But who knows? When talking to Washington reporters they proclaim their single-minded dedication to fiscal prudence; when talking to the home folks, they brag about their skill at pork barreling. So as sentinels of the public treasury, they have about as little credibility as the Republicans who used to control Congress.

If the Blue Dogs were truly worried about wasteful spending, they might use their influence to curb the outrageous looting of the federal Treasury by defense contractors, which remains by far the largest drain on the public purse. They might have spoken out against the brazen theft of billions of dollars by private contractors in Iraq, whose thievery harmed troops as well as taxpayers. They might have cautioned against squandering hundreds of billions of dollars on programs that don't work and probably never will, from the F-22 jet fighter to the Ballistic Missile Defense System.

Yet with precious few exceptions, the Blue Dogs whisper nary a word against military extravagance. If they are like Ross, they mindlessly endorse the expansion of virtually any and all military programs, simply because some of those dollars end up in their districts. At a time when the Pentagon's annual cost overruns approach $300 billion a year -- dwarfing the entire defense budgets of most developed countries -- these "fiscal watchdogs" simply have nothing useful to say on the subject. Their silence is regularly shamed, or should be, by the efforts of Sen. John McCain, R-Ariz., an actual conservative who at least tries to trim around the fattiest edges of the defense budget.

If the Blue Dogs aren't really worried by wasteful spending, then what do they find so troubling about the prospect of change in healthcare? The unflattering answer, which may be found in a study just released by the Center for Public Integrity, is money. Corporate interests are showering dollars on the Blue Dogs and their political action committees in record amounts. The center's analysis of the latest campaign financial data shows that well over half of the Blue Dog PAC's million-dollars-plus over the past six months came from three industries -- energy, finance and healthcare. Much the same pattern pertains to the individual PACS maintained by Ross and the other Blue Dog leaders. These pooches heel when the lobbyists whistle.

But why would we expect anything else from them?

Let's recall that the founder of the House Blue Dog caucus -- and still a guiding mentor to its members -- is Billy Tauzin, a Democrat from Louisiana who helped start the group in 1994 and then jumped ship to the Republicans a year later. Just months before he retired from Congress in 2005, he pushed through the Medicare prescription drug bill, guaranteeing hundreds of billions in waste and enormous profits for the drug companies.

As soon as he left Congress, Tauzin became the chief lobbyist for the Pharmaceutical Research and Manufacturers of America, where he makes sure the Blue Dogs never get carried away with any of that rhetoric about fiscal prudence or holding down costs -- by writing generous checks.

Copyright ©2009 Salon Media Group, Inc.